Tools to Help You Make an Informed Decision
Welcome to the Evolve Expert Library. Drawing heavily from medical literature, this section of our site aims to provide you with a deeper and more technical understanding of obesity and weight loss surgery. It’s just one more way we help our patients make as informed a decision about their healthcare as possible.
Obesity the Disease
Before you can make an informed decision on weight loss surgery, you must first understand the disease these procedures are used to treat. In the past, obesity was considered to be caused by a person’s lack of control and overeating. However, within the last couple of decades, the World Health Organization and national medical societies now recognize obesity as a chronic progressive disease resulting from environmental and genetic factors.
How is Obesity Calculated?
Simply put, obesity is characterized by excessive fat accumulation. Body Mass Index, or BMI, remains the most commonly used tool to measure a person’s level of fat. Individuals with a BMI of 30 or higher are considered obese. Below is a range of obese classes as defined by the ASMBS.
- BMI 30-34.9 is categorized as Class I, Obese
- BMI 35-39.9 is categorized as Class II, Seriously Obese
- BMI 40 and above is categorized as Class III, Severely Obese
The Prevalence of Obesity
Do you feel alone in your struggle to regain control of your weight? The numbers below prove you’re not.
- Worldwide obesity has more than doubled since 1980
- About 600 million adults in the world are affected by obesity (including 48 million children)
- Over one-third of the US adult population is obese
- Nearly 20% of adolescents are affected by obesity
What Causes Obesity?
There are a handful of factors, including hormones, metabolism, psychology, culture and behavior that promote fat accumulation and weight gain. Fundamentally, these factors lead to an imbalance in energy. The energy you are consuming through calories exceeds those you are burning daily. As you accumulate more fat, your body’s biology changes promoting additional weight gain. Essentially, obesity feeds more obesity.
Surgical Intervention for Obesity
People with severe obesity find themselves struggling with weight, unable to make any serious weight loss with conventional methods such as diet and exercise. At this point, your hormones and body are conditioned to store excessive fat.
The Impact of Obesity
Per the National Institutes of Health (NIH), obesity is the second leading cause of preventable death in the United States. In fact, obesity increases a person’s risk to develop additional medical problems which can diminish life expectancy. We take an in-depth look at these common comorbidities of obesity below.
It’s important to note that most, if not all, of these comorbidities can be diminished after weight loss surgery.
People affected by obesity are about 10 times more likely to have Type 2 diabetes than normal weight individuals. This doubles the risk of death and can lead to a series of additional complications such as: amputations, heart disease, stroke, blindness, impotence, kidney disease and high blood pressure. On the bright side, studies have shown weight loss surgery causes type 2 diabetes to go into remission in nearly 80% of individuals as it reduces the blood sugar levels and eliminates needs for diabetes medications.
Obesity has been strongly linked to high blood pressure, also known as hypertension. 75% of hypertension cases are related to obesity. With high blood pressure, a person becomes susceptible to heart disease, congestive heart failure, stroke and kidney disease. Weight loss surgery has helped our patients improve and even resolve their high blood pressure.
The American Heart Association considers obesity a major risk factor for heart disease. People with obesity are at a higher risk of having a heart attack and are at increased risk of heart failure and irregular heartbeats. By treating obesity with weight loss surgery, a patient can reduce the risk of heart disease.
Nearly 60% of obese individuals have obstructive sleep apnea. Sleep apnea causes a person to stop breathing for a short period. Not only does it reduce the amount of oxygen in a person’s blood, but it also interrupts the normal sleep cycle individuals to feel fatigued and drowsy. 98% of weight loss surgery patients will see their sleep apnea disappear.
As your BMI increases, so does your risk of cancer and death from cancer. On average, the death rate for all types of cancer increases in an obese individual. The death rate for women is a little higher at 62%, while the death rate for men is at 52%.
GERD, more specifically called gastroesophageal reflux disease, occurs when stomach acid flows back into the esophagus. Many patients cite heartburn as the main symptom of this disease. Research has shown that obesity can increase the risk and even worsen an already existing condition of heartburn as excess weight puts additional pressure on this portion of the esophagus. Nearly 100% of patients have seen heartburn symptoms disappear after weight loss surgery.
The Cost of Obesity
Obesity is a global epidemic whose cost has dire ramifications for economies all over the world. Below we look at how the cost of obesity impacts not only the United States, but also your wallet.
- Obesity drives nearly $210 billion in healthcare costs per year in the United States.
- Obesity is associated with job absenteeism, costing the US nearly $4.3 billion annually.
- Obese individuals spend 42% more on medical expenses than normal weight individuals.
- It costs emergency rooms 41% more to treat a severely obese person than healthy-weighted individuals.
- An obese person spends $6,100 more a year on groceries and dining out than a normal weight individual.
Considering costs of obesity, weight loss surgery should be seen as an investment. Within 2 to 4 years of your procedure, you can save on average $11,000 a year on food and medical expenses. Read more about how this works here.
At Evolve, we believe in practicing and supporting evidence-based medicine, so we keep up with the clinical literature surrounding both obesity and obesity treatments. A vast and growing number of peer-reviewed, scientific studies has examined obesity from many angles – causes, co-factors, and treatments, to name a few. Some studies directly compare treatment methods, others concentrate on understanding the mechanisms of one particular method or condition, and others present unique cases that might inform the direction of future research.
For those who would like to peruse the medical literature as physicians see it, we are compiling a list of important studies here. Each listing includes the scientific citation (the name of the author, the title, and publication data), a brief synopsis of the key questions and conclusions of the research, and a link to the full study or an abstract of the study, whichever is available online.
Gloy VL. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 2013;347:f5934
Meta-analysis on the overall effects of bariatric surgery compares with non-surgical obesity treatment. Conclusions: Compared with non-surgical treatment of obesity two years post-operation, weight-loss surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome. read more
Henry Buchwald, MD, et al. Bariatric Surgery: A Systematic Review and Meta-analysis. JAMA. 2004;292(14):1724-1737. doi:10.1001/jama.292.14.1724.
Meta-analysis on various forms of weight-loss surgery in and their effects on percentage of excess weight lost and other co-factors. Conclusions: “Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery. A substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.” Individual variables showed complete resolution of diabetes in 76.8% of patients; resolution of hypertension in 61.7% of patients; improvement of hyperlipidemia in 70% or more of patients; and resolution of sleep apnea in 85.7% of patients. read more